Medicaid Expansion as a Rural Issue: Rural and Urban States and the Expansion Decision

This report looks at the differences between rural and urban states in their decision on expanding the Medicaid program as provided for in the Affordable Care Act.

More rural states appear to be less likely to expand Medicaid. Thus a significant number of low-income, working rural residents are left in a "coverage gap." They earn too much to qualify for Medicaid, but not enough to qualify for health insurance marketplace premium tax credits.

In non-expansion states, rural health care provider networks, a safety net for the uninsured, will be stretched, possibly to the breaking point. Rural communities may be left without crucial pieces of the health care foundation, all rural residents may be left without institutions to attend to their health care needs, and small towns may be denied jobs and economic activity.

Download the Medicaid Expansion as a Rural Issue report below!